Clostridium difficile: Yeni Bir Gıda Patojeni mi?

Doğada yaygın olarak bulunan Clostridium difficile, antibiyotik ilişkili ishal, pseudomembranöz kolit ve fulminant kolitolmak üzere çeşitli klinik tabloların şekillenmesine sebep olabilen nozokomiyal fırsatçı bir patojendir. Antibiyotiğe bağlıishallerin %15-25’inden, psödomembranöz kolitlerin hemen hemen hepsinden sorumlu olduğu düşünülen C. difficile’inhipervirülan suşlarının ise genellikle nüks oranı yüksek ve şiddetli enfeksiyonlara hatta ölüme yol açtıkları bilinmektedir. C.difficile’in gıdalardan insanlara bulaşarak enfeksiyon yaptığına dair henüz yeterli veri bulunmamakla birlikte son yıllardayapılan çalışmalarda C. difficile enfeksiyonlarında çarpıcı bir artış olduğunun belirtilmesi, etkenin aynı zamanda hayvansalgıdalardan, çiğ veya tüketime hazır gıdalardan, sebzelerden, salatalardan, deniz, göl ve nehir sularından, su ürünlerinden,topraktan ve çeşitli çevresel numunelerden izole edilmiş olması, C. difficile’in gıda kaynaklı bir patojen olup olmadığı sorusunuakla getirmektedir. C. difficile’in gıdalarda tespit edilen bazı suşlarının toksijenik özellik taşımaları, antibiyotiklere karşı değişenoranlarda dirençli olmaları ve zor şartlara dayanıklı endosporları sayesinde kolayca yayılabilme özellikleri ise bu bakterininönemini giderek arttırmaktadır. Bu derlemede C. difficile’in genel özellikleri, patojenitesi, enfeksiyon kaynakları, risk faktörleri,gıdalarda varlığı, gıdalardan izolasyonu ve identifikasyonu hakkında bilgilere yer verilmiştir.

Clostridium difficile: Is it a New Food-Borne Pathogen?

Clostridium difficile, commonly found in nature, is a nosocomial opportunistic pathogen which causes formation of various clinical disorders including antibiotic associated diarrhea, fulminant colitis and pseudomembranous colitis. C. difficile is thought to be responsible for almost all of the pseudomembranous colitis and 15-25% of the antibiotics related diarrhea. Also it is known that hypervirulent strains generally have high recurrence rate and cause severe infections or even death. Although there is not enough data that C.difficile infects people by transmition via food, there is a significant increase in infections caused by C. difficile in recent studies. In addition to this knowledge bacteria have been isolated from various samples which animal foods, raw or ready to eat foods, vegetables, salads, the waters of sea, lake and river, seafood, soil and environmental samples. All of these bring to mind a question that C. difficile is whether or not a food-borne pathogen. Toxigenic characteristics of some strains of C. difficile detected in foods, resistance to antibiotics in various ratios and their spreading easily properties due to endospores resistant to difficult conditions have further increased the importance of this bacterium. In this review, the information about general characteristics, pathogenesis, infection sources, risk factors, presence in food, isolation from food and idendification of C. difficile have been given.

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